Review Question - QID 107038

This patient is experiencing synesthesia (stimulation of one sensory pathway leads to involuntary experience of a second sensory pathway) and is most likely having a "bad trip" after using lysergic acid diethylamide (LSD). LSD acts on the 5-hydroxytryptamine (i.e. serotonin, 5-HT) receptor and the dopamine 2 receptor.

LSD is a recreational drug used for its psychological effects such as synesthesia, altered sense of time and identity, visual hallucinations, and producing "spiritual experiences." At times, the altered state can transform into dissociation, despair, and anxiety, which is colloquially termed a "bad trip." There is no medical treatment for a "bad trip," and it may last for up to 12 hours. Some of the physical effects of LSD consumption are dilated pupils, hyperthermia, sweating/chills ("goosebumps"), loss of appetite, dry mouth, and tremors. LSD functions primarily by acting on 5-HT and D2 receptors. There are no withdrawal symptoms, but individuals have experienced flashbacks of their "high" several years later.

Incorrect Answers:
Answer 1: Marijuana, more specifically tetrahydrocannabinol (THC), acts on the cannabinoid receptor.
Answer 3: Ketamine and PCP act on the NMDA receptor. Ketamine can present with dissociative symptoms and hallucinations; however, a patient on ketamine is less likely to be, "screaming," and experiencing such severe symptoms. A more common presentation would be a depersonalized/detached state in addition to hallucinations.
Answer 4: Benzodiazepines act on the GABA receptor.
Answer 5: Opiates act on the mu opioid receptor.